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General NPI Number Information
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NPI Number | 1922391721
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Entity Type | Organization
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Legal Business Name | MGM CASE MANAGEMENT SERVICES
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Dates
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Enumeration Date | 05/26/2011
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Last Update Date | 10/16/2020
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Provider Practice Location Address
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Address Line | 8040 NW 155TH ST # 320
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City | MIAMI LAKES
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State | FL
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Zip | 33016-5880
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Country | US
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Telephone | 305-827-2822
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Fax |
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Provider Business Mailing Address
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Address Line | 14411 COMMERCE WAY 320
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City | MIAMI LAKES
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State | FL
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Zip | 33016-1596
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Country | US
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Telephone | 786-597-3928
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | SAIMARY RIVERO
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Credential | BCBA
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Telephone | 305-827-2822
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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